High prevalence of primary drug resistance in children with intrathoracic tuberculosis in India. (2nd July 2016)

• Record Type: Journal Article
• Authors: Prajapati, Suneel; Upadhyay, Kriti; Mukherjee, Aparna; Kabra, S. K.; Lodha, Rakesh; Singh, Varinder; Grewal, Harleen M. S.; Singh, Sarman
• Is Part Of: Paediatrics and international child health. Volume 36:Number 3(2016:Aug.)
• Page Start: 214
• Page End: 218
• Publication Date: 2016-07-02
• Subjects: Tuberculosis -- Multi-drug-resistant TB -- Rifampicin -- Gastric lavage -- Induced sputum -- India; Pediatrics -- Developing countries -- Periodicals; Children -- Health and hygiene -- Developing countries -- Periodicals; Children -- Diseases -- Developing countries -- Periodicals; 618.920009172405
• DOI: 10.1179/2046905515Y.0000000041
• Languages: English
• ISSNs: 2046-9047

Abstract

Abstract : Background: Drug susceptibility testing (DST) of Mycobacterium tuberculosis ( Mtb ) isolates is crucial for the effective treatment of tuberculosis. Data on DST patterns in Mtb isolates in childhood tuberculosis are scanty. Aims: To determine drug resistance patterns in Mtb isolates from a paediatric TB cohort in North India. Methods: 403 children aged 6 months to14 year with probable intrathoracic tuberculosis were enrolled prospectively. All were treatment-naïve. 802 ambulatory-induced sputa (IS) and 787 gastric aspirate (GA) samples were cultured in BACTEC-MGIT960 system, and DST of the Mtb isolates was undertaken using the automated BACTEC-MGIT960 SIRE kit. Results: Of the 403 children, 147 (36.4%) were culture-confirmed: 132 (89.8%) isolates were Mtb and 15 (10.2%) non-tuberculous mycobacteria (NTM). Five Mtb isolates were contaminated and the remaining 127 were subjected to in-vitro drug susceptibility testing against streptomycin, isoniazid, rifampicin and ethambutol. Twenty-six (20.47%) isolates were resistant to one or more drugs, seven (5.5%) were resistant to rifampicin singly or in combination, and 11 (8.7%) were resistant to isoniazid singly or in combination. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol was detected in four (3.1%), one (0.8%), four (3.1%) and two (1.6%), respectively. Five children (3.9%) had MDR-TB; 101 (79.9%) children had Mtb isolates which were sensitive to all four drugs. Conclusions: The rifampicin and isoniazid resistance rates were much higher than those in the adult TB population in India.